How do you scare someone with osteoarthritis (unnecessarily)?

Tell them things like:

• ‘You’ve got bone on bone.’
• ‘It’s caused by wear and tear.’
• ‘It’s only going to get worse.’

Is it time to stop saying such strong statements?

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Knee osteoarthritis (OA) is a condition involving changes in the knee joint (e.g., cartilage), which can sometimes be associated with knee pain and joint stiffness.

A common misconception is that knee OA is just ‘wear and tear’ and only gets worse with time.

Another misconception is that the only treatment option is a total knee replacement, where the surfaces of your bones are surgically replaced with metal and plastic. Part of this belief stems from non-surgical treatments (e.g., diet and exercise) not technically ‘restoring’ cartilage.

However, it’s critical to realise that you can reduce your pain without changing your tissue. Also, more severe knee OA on imaging doesn’t necessarily mean more pain.¹ In fact, knee OA is prevalent in people with ‘no’ pain: 4‒14% of asymptomatic adults aged <40 years and 19‒43% of adults ≥40 years on MRI.²

There’s also strong research to show that exercise can have positive effects on pain and function.³

Moreover, non-surgical treatments can avoid the risks associated with surgery, such as infection.

Non-surgical interventions, including education, exercise and weight loss (if relevant), are recommended as first-line treatments for knee OA because they’re effective, simpler and safer. Surgery can be a suitable option for those who don’t respond well to such interventions.

For more information, you can check out the decision aid below.⁴

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References:

1. Finan et al. (2013) (PMID: 22961435)
2. Culvenor et al. (2019) (PMID: 29886437)
3. Fransen et al. (2015) (PMID: 26405113)
4. https://www.safetyandquality.gov.au/sites/default/files/migrated/OAK-DST-FINAL-APRIL-8.pdf
5. Image source: https://www.injurymap.com/diagnoses/osteoarthritis-of-the-knee